Which reading accurately describes hypertension?

NORCET 2 - 2021 (shift-1)

Medical Surgical Nursing

Easy

Appeared in: NORCET 2 - 2021 (shift-1)

Explanation

A blood pressure reading of 160/104 mm Hg meets the criteria for Stage 2 Hypertension.
According to the 2017 ACC/AHA guidelines, Stage 2 Hypertension is defined as a systolic blood pressure of 140 mm Hg or higher OR a diastolic blood pressure of 90 mm Hg or higher.
In this case, both the systolic (160 mm Hg) and diastolic (104 mm Hg) values exceed the thresholds for Stage 2, making it a clear example of hypertension.

Option A: A reading of 110/90 mm Hg has a normal systolic pressure but a high diastolic pressure. This is known as isolated diastolic hypertension (Stage 1), not a representation of overall hypertension where both values are typically elevated.
Option B: A reading of 118/87 mm Hg is classified as Elevated Blood Pressure (or prehypertension). The systolic is normal (less than 120), and the diastolic is in the Stage 1 range (80-89), but it does not meet the full criteria for a hypertension diagnosis.
Option D: A reading of 119/82 mm Hg is also classified as Elevated Blood Pressure. The systolic is normal, and the diastolic is in the Stage 1 range, but it is not high enough to be diagnosed as hypertension.

Visual 1: Chart: A color-coded chart illustrating the different blood pressure categories (Normal, Elevated, Stage 1, Stage 2, Hypertensive Crisis) with their corresponding systolic and diastolic ranges. This provides a quick visual reference for classification.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Blood pressure classification and diagnosis of hypertension as background academic context rather than a clinical decision trigger.
Hypertension is often called the 'silent killer' because it usually has no symptoms but is a major risk factor for heart disease, stroke, and kidney failure. Accurate BP measurement and classification are fundamental nursing skills.
Nurses play a crucial role in patient education regarding lifestyle modifications, such as diet, exercise, and stress management, which are essential for managing hypertension.
What if? If a patient's reading was 135/88 mm Hg on a single visit, this would be classified as Stage 1 Hypertension. The nurse's priority would be to schedule follow-up appointments to confirm the diagnosis (as it requires readings from at least two separate occasions) and to initiate education on lifestyle changes, rather than immediately starting medication.

How to Approach the Question

First, recall the standard blood pressure classification guidelines (Normal, Elevated, Stage 1, Stage 2).
For each option, identify the systolic (top number) and diastolic (bottom number) pressures.
Compare each pair of values against the established ranges for each category.
Note that for Stage 1 and 2 hypertension, only one of the values (either systolic OR diastolic) needs to be in the high range.
Select the option that most clearly and definitively falls into a hypertensive category (Stage 1 or 2).

Concept Tested & Keywords

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